FNP or MD?

Tiffanybaybay · May 25, 2012

Let me say first off, I'm neither a MD or FNP.

However I've been searching for the same answers as you have becuase I don't want to waste anymore time in school. I want to work towards what I want and not play around.

I honestly have scoured the internet and I have also started annoying all of my coworkers with the same questions.

So when I went to SDN I experienced A LOT of ANGER from the student MD's saying that NP's don't know what they don't know. They routinely misdiagnose patients and don't know enough to diagnose correctly. Many came to the conclusion that basic BASIC medical practice is fine for a nurse practitioner but not anything more complicated than that.

However I think we are all aware that sooner rather than later NP's will be practicing EVERYWHERE with full scope of practice after some legal and constitutional battles fought with insurance company dollars. (I'm sure you're aware that NP's can't prescribe narcs in FL and somewhere else... frustrating! and NP's can't practice independently in many states.) Insurance companies definitely want cheaper practice tho so prepare to fight...

However I feel there are limitations to SDN because it's an internet site and they shouldn't even have enough time to write on forums during their residencies...

I asked a few MD's and residents at work, and they stated that they have no problems working with FNP's and they serve a purpose (in some situations) I think they felt that in a family practice setting or when DX are run of the mill FNP's can be useful. (They stated "I have no problem working with" because apparently some MD's have stated they prefer not, or will not work with NP's)

FNP's however are nothing more than a glorified Nurse in the medical world. It seems that they just have legal ability to help MD's focus on more complex dx and pt care.

Now when you consider the monetary involvement, FNP may be the better choice. You need at least 3 yrs of residency to be a GP where you make less than an RN with the burden of your med school bills on your back. I work with an RN at my job who completed medical school overseas. When he came here, instead of going through all the paperwork to start his residency he became an RN. He has a kid and said it just wasn't worth it. I've also had some MD's that have said in the end it's not worth the cost at yale they stated 1st year resident make around 40,000. And there didn't seem to be much increase in pay as they years increase. Other residencies are less $$ I'm sure, and remember 3 yrs is for general practice, more is required for specialties. Some MD's have $1700 in loan payments to make A MONTH! (that's kinda high but I think that includes their insurance) However those are ER MD's and they're not doing research or anything groundbreaking. (that's where a lot of money is)

In my experience, I had teachers that were NP's and they were AWESOME! I've worked in the ER with NP's and the ones I've worked with SUCK and were WAAAAY to SLOW!

As an NP you have to beware of the poor reputation they have in medical communities due to the rigors of the program and our nursing process. Most MD's appear to dislike the nursing process to say the least. They say it's not medical and doesn't require much thought. We don't require organic chem, etc to get into our programs, and many RN's are getting right into school after their BSN. Even if many people say this is an ok practice the medical world apparently approve since many PA schools require students to have some experience before beginning the program.

Also as an NP there doesn't seem to be a residency. I'd love to create my own, even if for a year. I think it is very appropriate to have NP's do a year or so after school ESPECIALLY if they have no experience entering into NP school.

SOOOOOO....

With all that being said, it seems that if you're in love with the art of medicine, or you want control of the entire care of your patient, or you want to create some groundbreaking surgical procedure then become an MD.

If you don't mind caring for the crappy pt's, doing med refills, and spending the next 10-15 yrs fighting for the advancement of NP rights become an NP. You will have less loans, but you will be subject to someone's elses decision making process and increasing insurance costs. (NP's are increasing in malpractice suits so the insurance costs are rising.)

PERSONALLY (gosh this is sooo long... LOL)

If I were you I'd go to DO school. DO's are looked down upon, but they actually have MORE training than MD's. Also in my ER we have at least 2 DO's that I can think of off hand. My dad goes to a DO in cali, that he pays cash for. This MD does spinal manipulation. My dad has had back pain his entire life with no relief, some MD's prescribe surgery or narcs. My dad had a "massage" from a DO, and the pain was gone. Let me emphasize this is NOT chiropractor.... not to mention my dad pays big bucks for this. I personally want to get more into care for the WHOLE patient, naturopathy, and nutritional medicine, so I think DO's are better, but like I said they are looked down upon.

The idea of loans that high is intimidating to say the least, but I hear ER MD's make $500,000 a yr... GP's around $200,000/yr. The cardiac surgeons I know of make salary plus $5,000 PER case! Salary.com I think says they make on average $80.00/hr, which sux because NP's average $40.00/hr.

If you want to do family practice, go NP. If you desire to get your hands dirty with some serious research, or any type of specialty, go MD or DO.

Ok I think that's all I have to say...

(ain't that enough?) Good luck.

Tiffanybaybay · May 25, 2012

BTW I heard an RN-MD state she had no advantage in residency over other residents except in bedside manner. ~true story~